Quadriceps wasting and physical inactivity in patients with COPD

Dinesh Shrikrishna*, Mehul Patel, Rebecca J. Tanner, John M. Seymour, Bronwen A. Connolly, Zudin A. Puthucheary, Simon L.F. Walsh, Susannah A. Bloch, Paul S. Sidhu, Nicholas Hart, Paul R. Kemp, John Moxham, Michael I. Polkey, Nicholas S. Hopkinson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

209 Citations (Scopus)


Quadriceps weakness is an important complication of advanced chronic obstructive pulmonary disease (COPD) but few data exist concerning muscle bulk in early disease. We hypothesised that quadriceps bulk, measured by ultrasound rectus femoris cross-sectional area (USRFCSA), would be reduced in mild, as well as advanced, COPD compared with controls, and would correlate with physical activity. 161 patients with stable COPD and 40 healthy subjects had a measurement of USRFCSA and wore a multisensor armband to record physical activity. USRFCSA was reduced in Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I patients compared with healthy subjects (p=0.0002). Stage II-IV patients had reduced USRFCSA (p<0.0001) compared with controls but were not significantly different from those with stage I disease. Physical activity level was reduced in stage I (p=0.002) and stage II-IV disease compared with controls. Using regression analysis, physical activity level was independently associated with USRFCSA in stage I (p=0.01) but not stage II-IV disease, where residual volume to total lung capacity ratio was the only independent predictor of physical activity level. Quadriceps wasting exists in patients withmild, as well as advanced, COPD, and is independently associated with physical inactivity in GOLD stage I disease. The identification of these patients may guide early lifestyle and therapeutic interventions.

Original languageEnglish
Pages (from-to)1115-1122
Number of pages8
JournalEuropean Respiratory Journal
Issue number5
Publication statusPublished - 01 Nov 2012
Externally publishedYes


  • Mild chronic obstructive pulmonary disease
  • Skeletal muscle
  • Ultrasound rectus femoris cross-sectional area

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


Dive into the research topics of 'Quadriceps wasting and physical inactivity in patients with COPD'. Together they form a unique fingerprint.

Cite this